Provider Demographics
NPI:1710187307
Name:RICHARD B. VIEHE DPM, INC.
Entity Type:Organization
Organization Name:RICHARD B. VIEHE DPM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:VIEHE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:949-760-6907
Mailing Address - Street 1:1303 AVOCADO AVE
Mailing Address - Street 2:STE 195
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7802
Mailing Address - Country:US
Mailing Address - Phone:949-760-6907
Mailing Address - Fax:949-706-6962
Practice Address - Street 1:1303 AVOCADO AVE
Practice Address - Street 2:STE 195
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7802
Practice Address - Country:US
Practice Address - Phone:949-760-6907
Practice Address - Fax:949-706-6962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1439213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWE7921AMedicare PIN
CAWE7921Medicare PIN